Quickhit: “Pit to distress”

Unnecesarean, Nursing Birth, and other bloggers are talking about an unofficial protocol used by some obstetricians, “Pit to distress”. Check it out at these links, which explain the background and the reality on the ground.

tigtog: I can attest that there are plenty of doctors who believe they are far less likely to be sued for “vaginal bypass surgery” – whatever the outcome – than for “allowing” birth. And they’re not necessarily always all that far off the mark, I think: over the past decade or so, there’s been a pretty strong societal idea that babies die because of vaginal birth, but in spite of intervention. (Substitute “homebirth” and “hospital birth” for similar ideas.) It’s the “we did all we could” effect.

I feel physically sick, reading that.
A friend of mine recently gave birth in a top private hospital (which, uncoincidentally, has the highest C-sec rate in SA; over 50%, and over 60% for first births). Her waters broke without contractions, she was told to come in, and they decided to induce her then and there. The protocol for most places is 24 hours after waters break, as I understand it. This was 6.
(By way of reference, my waters broke early too, but I was with a very low-intervention hospital who gave me the choice of avoiding intervention in the same circumstances. It was close to 3 days before contractions started. It’s not always the case that waters breaking mean that the body is completely ready for labour.)
They started the pit, and turned it up, and turned it up. They turned it up high enough that the midwife on duty was asking if it was safe – and if a midwife at a private hospital is showing concern*, you know it’s gotta be pretty extreme, right? Her OB replied that it was fine until and unless the fetal heart rate showed distress. Until that time, if contractions hadn’t kicked in, he considered it was perfectly fine to keep upping the dosage.
Contractions hit like a truck, she asked for the epi within half an hour, and delivered numb from the waist down, with forceps. She avoided a c-section only because the labour was so quick; 3 hours from onset of contractions.
That story was told to me as a ‘she had a great labour’ tale. I knew there was something wrong with it from the start, but found it hard to articulate because in her case, it ended well – no distress, no section. But her ob’s modus op was to up the pit as much as it took, on the grounds that until there was visible distress it was fine. Although there was no reason to hurry the labour; no meconium, no infection, no complicating factors. Just pit ‘er up.
Ugh.
*Not because they’re less caring, of course, but because they’re more used to seeing high intervention practises. And because I’m guessing the hierarchy keeps them quieter, although I could be wrong on that.